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Effectiveness of implementing a Best Practice Guideline recommendations to manage pain in oncological hospitalized
Ana-Isabel Alcañiz-Mesas1, María-Victoria Ruiz-García2, María-Pilar Córcoles-Jiménez3
1Unidad de Oncología y Hematología, Hospital General de la Gerencia de Atención Integrada de Albacete, Albacete, Spain; Grupo de investigación NurSearch CLM, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Castilla-La Mancha, Spain.
Objective:
To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) "Assessment and Management of Pain" recommendations for pain control in oncological/oncohaematological hospitalized patients.
Methods:
Ambispective cohort study.
Sample And Setting:
Adults admitted to oncological unit in Hospital of Albacete.
Intervention:
Implementation of GBP recommendations.
Variables:
1) Demographic data. 2)On implementation of GBP recommendations. 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales.
Data Collection:
indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018-2019); sustainability (T3 = 2021-2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: p < 0.05.
Results:
Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%-T0; 98.3%-T1; 98.4%-T2; 91.2%-T3; p < 0.001), pain assessment using an appropriate scale in 97.6% (558) (0%-T0; 98.3%-T1; 99.2%-T2; 100%-T3; p < 0.001); 93.7% (535) had a care plan for assessment and management of pain (0%-T0; 98.3%-T1; 96.3%-T2; 92.3%-T3; p < 0.001). The percentage of patients who had severe pain (6-10) during the first 24 hours was reduced from T1 to T3 (5.1%-T1; 6.6%-T2; 2.1%-T3; p = 0.145), but throughout hospitalization increased from T1 to T3 (19.2%-T1; 17%-T2; 22.5%-T3; p = 0.21).
Conclusions:
Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.
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